Clinical Observation and CT Findings of Hypertensive Intracerebral Hemorrhage.

Kim, J H; Park, K Y; Kang, J K

Original Article

Journal of Korean Neurosurgical Society 1980;9(1): 83-94.

Department of Neurosurgery, Catholic Medical College, Seoul, Korea.

ABSTRACT

An analysis has been made of the clinical observation and CT finding in 21 adult patients(17 male, 4 female) of hypertensive intracerebral hemorrhage who were admitted to the Catholic Medical Center from January 1978 to August 1979. Repeated CT scans were performed in 5 patients, one of them included 2 repeated scans. The following results were obtained. 1) All of the patients had a long-term history of hypertension, usually over 3 to 10 years. 10 of them were associated with diabetes mellitus. 2) In the age distribution, the 6 th decade was most frequently involved, 11 among 21 patients(52.3%). 3) The most frequent site of hypertensive intracebral hemorrhage was basal ganglia in 42.8%;followed by thalamic 23.8%, subcortical 28.6% and cerebellar 4.8%, Intraventricular hemorrhage occurred in 28.6% and there was no definite difference in the ratio of occurrence between the dominant hemisphere and the non-dominant hemisphere. 4) Calculated amounts of hematomas based on CT scans ranged 10-70 cc, averaged by 29.2 cc. 5) Intracerebral hematomas were shown as high density areas in all cases examined until 11 days after the onset, ranging 35-70(average 40) EMI units. In 3 cases examined one month later the onset, they showed low density near to that of CSF. 6) Perifocal low density areas could be recognized in all cases within 11 days, but they were most prominent within 4 days and then progressively diminished by the passage of time, ultimately disappearing after one month. 7) Mass effects were noted in all cases examined within one week after the onset. Thereafter they gradually decreased to minimal degree in 6 cases until 11th day. 3 cases examined after one month did not show any mass effects. 8) Contralateral ventricular dilatation was shown in 11 cases(52.4%), ipsilateral ventricular collapse in 15 cases(72.4%). After one month, various degree of ipsilateral ventricular dilation was noted. 9) High density areas of intraventricular hemorrhage disappeared in 2 cases examined 7 days after the onset. 10) Surgical and conservative treatment for hypertensive intracerebral hemorrhage resulted 6 death, 4 with severe disability and 8 with fair result as to perform daily life partially assisted. Only 3 cases were cured.